First symptoms and health care pathways in hospitalized patients with acute heart failure: ICPS2 survey. A report from the Heart Failure Working Group (GICC) of the French Society of Cardiology.
comorbidities
healthcare pathway
heart failure
hospitalization
risk factors
symptoms
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
revised:
26
04
2021
received:
19
01
2021
accepted:
26
05
2021
pubmed:
27
6
2021
medline:
16
10
2021
entrez:
26
6
2021
Statut:
ppublish
Résumé
Acute heart failure (AHF) is a common serious condition that contributes to about 5% of all emergency hospital admissions in Europe. To assess the type and chronology of the first AHF symptoms before hospitalization and to examine the French healthcare system pathways before, during and after hospitalization. A retrospective observational study including patients hospitalized for AHF RESULTS: 793 patients were included, 59.0% were men, 45.6% identified heart failure (HF) as the main cause of hospitalization; 36.0% were unaware of their HF. Mean age was 72.9 ± 14.5 years. The symptoms occurring the most before hospitalization were dyspnea (64.7%) and lower limb edema (27.7%). Prior to hospitalization, 47% had already experienced symptoms for 15 days; 32% of them for 2 months. Referral to hospital was made by the emergency medical assistance service (SAMU, 41.6%), a general practitioner (GP, 22.3%), a cardiologist (19.5%), or the patient (16.6%). The modality of referral depended more on symptom acuteness than on type of symptoms. A sudden onset of AHF symptoms led to making an emergency call or to spontaneously attending an emergency room (ER), whereas cardiologists were consulted when symptoms had already been present for over 15 days. Cardiologists referred more patients to cardiology departments and fewer patients to the ER than general practitioners or the SAMU. This study described the French healthcare system pathways before, during and after hospitalization AHF. AHF clinic network should be developed to provide adequate care for all HF patients and create awareness regarding AHF symptoms.
Sections du résumé
BACKGROUND
BACKGROUND
Acute heart failure (AHF) is a common serious condition that contributes to about 5% of all emergency hospital admissions in Europe.
HYPOTHESIS
OBJECTIVE
To assess the type and chronology of the first AHF symptoms before hospitalization and to examine the French healthcare system pathways before, during and after hospitalization.
MATERIAL AND METHODS
METHODS
A retrospective observational study including patients hospitalized for AHF RESULTS: 793 patients were included, 59.0% were men, 45.6% identified heart failure (HF) as the main cause of hospitalization; 36.0% were unaware of their HF. Mean age was 72.9 ± 14.5 years. The symptoms occurring the most before hospitalization were dyspnea (64.7%) and lower limb edema (27.7%). Prior to hospitalization, 47% had already experienced symptoms for 15 days; 32% of them for 2 months. Referral to hospital was made by the emergency medical assistance service (SAMU, 41.6%), a general practitioner (GP, 22.3%), a cardiologist (19.5%), or the patient (16.6%). The modality of referral depended more on symptom acuteness than on type of symptoms. A sudden onset of AHF symptoms led to making an emergency call or to spontaneously attending an emergency room (ER), whereas cardiologists were consulted when symptoms had already been present for over 15 days. Cardiologists referred more patients to cardiology departments and fewer patients to the ER than general practitioners or the SAMU.
CONCLUSION
CONCLUSIONS
This study described the French healthcare system pathways before, during and after hospitalization AHF. AHF clinic network should be developed to provide adequate care for all HF patients and create awareness regarding AHF symptoms.
Identifiants
pubmed: 34173675
doi: 10.1002/clc.23666
pmc: PMC8364729
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1144-1150Informations de copyright
© 2021 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.
Références
Eur J Heart Fail. 2013 Apr;15(4):465-76
pubmed: 23186936
J Am Coll Cardiol. 2014 Apr 1;63(12):1123-1133
pubmed: 24491689
Am J Med. 2008 Mar;121(3):212-8
pubmed: 18328305
Arch Cardiovasc Dis. 2019 Nov;112(11):723-731
pubmed: 31542331
Eur J Heart Fail. 2011 Mar;13(3):235-41
pubmed: 21159794
Eur J Epidemiol. 2019 Mar;34(3):301-317
pubmed: 30830562
Arch Cardiovasc Dis. 2013 Nov;106(11):570-85
pubmed: 24140417
BMJ Open. 2016 Nov 30;6(11):e013459
pubmed: 27903565
Eur J Heart Fail. 2020 Apr;22(4):723-725
pubmed: 32072715
J Card Fail. 2012 Jul;18(7):576-84
pubmed: 22748492
J Am Coll Cardiol. 2015 Jul 28;66(4):403-69
pubmed: 25553722
J Card Fail. 2008 Dec;14(10):801-15
pubmed: 19041043
BMJ Open. 2017 Mar 10;7(3):e013648
pubmed: 28283487
Rev Esp Cardiol (Engl Ed). 2016 Oct;69(10):940-950
pubmed: 27576081
Heart Lung. 2001 Sep-Oct;30(5):351-9
pubmed: 11604977
ESC Heart Fail. 2020 Feb;7(1):15-25
pubmed: 32100972
Arch Cardiovasc Dis. 2017 Jan;110(1):42-50
pubmed: 28017276
Int J Cardiol Heart Vasc. 2019 Dec 05;26:100448
pubmed: 31867437
JACC Heart Fail. 2013 Aug;1(4):273-280
pubmed: 24159563
Arch Cardiovasc Dis. 2014 Mar;107(3):158-68
pubmed: 24662470
Lancet. 2018 Nov 10;392(10159):1789-1858
pubmed: 30496104
Eur J Heart Fail. 2007 Jun-Jul;9(6-7):702-8
pubmed: 17188930
J Am Coll Cardiol. 2013 Jan 15;61(2):121-6
pubmed: 23273288
Am J Med. 2003 Jun 1;114(8):625-30
pubmed: 12798449
Arch Cardiovasc Dis. 2017 Feb;110(2):72-81
pubmed: 27693052
Eur J Heart Fail. 2010 Oct;12(10):1122-9
pubmed: 20685686
BMC Cardiovasc Disord. 2012 Sep 25;12:81
pubmed: 23009030
Clin Cardiol. 2021 Aug;44(8):1144-1150
pubmed: 34173675